Past, Present, and Future of Hepatitis B and Fatty Liver in Bangladesh

Chronic hepatitis B (HBV) is one of the major diseases of mankind, estimated to cause about 686,000 deaths per year mostly from liver cancer and cirrhosis. And globally about 240 million people are chronically infected with hepatitis B. Nonalcoholic fatty liver disease (NAFLD) is an emerging commonest cause of chronic liver disease in the world. We have searched for CHB, NAFLD in PUBMED, Google scholar and hard copies of local journals and related available articles were included in this review. Along with 184 countries of the world Bangladesh adopted hepatitis B vaccine in his EPI (expanded program on immunization) schedule for its prevention. And now about 95% of children are under cover of Hep B vaccine. Along with globally inlast two decades’ seroprevalence of HBsAg reduced about four times in Bangladesh. The prevalence of recorded nonalcoholic fatty liver disease (NAFLD) varies considerably by ethnic group and Bangladeshi ethnicity is an independent risk factor for NAFLD. The prevalence of NAFLD in Bangladesh is vary from 4%-18.4% and it is increasing day by day. About 40% of them are nonalcoholic steatohepatitis (NASH). They are in danger of progression to cirrhosis and hepatocellular carcinoma (15-19%) in next 5 to 10 years. Now it’s becoming a silent killer for our nation. Gradual development of affluence, sedentary life style and increasing prevalence of diabetes contributed behind it. No effective treatment is available till now. Life style change by diet, exercise and weight reduction is the main stay of treatment. NAFLD involve multiple organs that leads to death due to cardiac, neurological and liver disease. Government and health department should take multidisciplinary action programs in awareness building and make a national guideline for fatty liver management.